Random thoughts from a few cantankerous American physicians. All contributors are board certified. Various specialties are represented here. I do not know where this will lead but hope it will at least be an enjoyable read. All of the names mentioned in this blog are pseudonyms, the ages have been changed, and in half the cases the gender as well. All photographs are published with patient consent or are digitally altered to preserve anonymity. Trust us, we're doctors.

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Thursday, April 12, 2007

Free piece of advice (sort of like 80% of my professional advice): if you have diabetes and you get a boo-boo on your foot, even if it doesn't hurt, get it taken care of. Do NOT let the wound get infected and eat into the bone, that is, unless you really enjoy hopping.

Got a foot in the lab today and I thought people may want to know what happens to your body parts when they get taken off of you.

So, here's how it is. First, cut off foot. Next, wrap in red bio-hazard bag, but forget to secure the opening so blood leaks on the hospital waiting-room carpet (true story). When the foot gets to me, I like to have a little fun. I put the appendage into the -80 degree freezer overnight. Why? Because frozen human tissue cuts exactly like wood on an industrial bandsaw. The following day, I open the freezer to a wonderful sight - a rock hard, ulcerated foot. Then to the aforementioned bandsaw. I make a sagittal cut, aiming the blade at roughly the gap between the 2nd and 3rd toes, and saw through the ankle joint. Smells like burning lamb chops. If I see a focus of osteomyelitis, I'll buzz a thin cut that gets fixed, paraffin-embedded, microtomed, stained, and looked at under the microscope.

The rest of the foot? This gets tossed into a vat of formaldehyde until the case is signed out. Then I chuck the whole mess into another big red bag that gets incinerated along with the placentas, colon cancers and aborted fetuses.

9 comments:

So, this morning my 3 year old son asked what they did with my thyroid (he pronounces it syroid because he's only 3)after they took it out and AFTER they looked at it with the microscope (the way he says that word is funny, but I can't figure out how to type it). I told him I had no idea. He has been hounding me all day, so I made a mental note to ask my doctor in a few weeks when I see him. You just saved me from being that annoying patient who asks a million useless questions. Thank you!

ah yes, the old severed body part. had a patient that may have cut off his own hand for insurance purposes. it's pretty creepy to see a human body part in a bag... reminds me of the scene in "the departed" when jack nicholson pulls a human hand out of a bag in front of leo dicaprio. my posts on the severed hand, which was reattached by hand surgeons, are below.

doc, i'm glad you do what you do or you might have found your calling in a very jeffrey dahmer-esque role... especially given the gay thing.

rad. girl: your 3 year old should know the whole story. The thyroid is a pretty small organ (o.k., I'm waiting for small organ jokes...). Probably the whole thing was submitted for microscopic examination. This means that your gland is sitting in some box in a storage facility, cut into thin slices and embedded in paraffin. We have to, by law, hold onto these tissues for 10 years. THEN we burn it up. I sincerely hope your cancer is gone from your body and you live long and breed more. Unfortunately, you seem like a cool, normal person - bad prognostic sign.

911doc: re. the gay thing. Is it gay to share a bowl of chili with another dude? 2 spoons, of course. Just wondering.

I have seen a lot of gory things while doing registration for the ED. I only felt queasy once. I was at the patient's bedside when the ED pulled out the gauze packing from an elderly lady who had presented there in the morning with epistaxis, only to return again that nite with the same thing. There was something about the movement in conjunction with the long bloody clot that came out with it that caused my stomach to flip flop. As soon as I was able to get out of there, I immediately went out back for some fresh air. I think body parts in a bag might do it to me too. Although I was fine when someone handed me a cup with a little girl's toes in it, but I think there was so much commotion surrounding that - that I was on auto pilot.

how do you know me so well that you knew to wait for the small organ joke?

10 years it stays there? That seems like a really long time. I probably won't tell him that part because he has been dying to actually see it, and if I told him it was still around I would hear about it every day of the remaining 10 years.

No more breeding for me. I had a hysterectomy about a year ago just after I turned 31. I do have four kids though. I think that's sufficient. I also think it is lucky that I had them young or I wouldn't have had them at all. (I graduated from college when I was 20, got married when I was 20 and had my first baby at 22. They were all planned except the last one).

I'll have to think on the chili thing. Perhaps if you sent me a picture of the two guys it would help. If they are prettier than me, then I would probably have my answer.

dear rad girl, the two guys involved are yours truly and etotheipi and we are butt-ugly. we shared the chili in a very manyly way... kinda warrior-like. i was wearing a viking helmet and my colleague was dressed as a roman senator with a toga. gay?

seaspray: the foot thing is the tip of the iceberg for gross-out stuff we see here in our windowless basement. More to come. Enjoy!!

Last bit on the gay thing: Maybe the chili thing is 'not-gay', however, when you follow it up by sipping out of another dude's Camelbak while he's still wearing it... kinda gay. And it wasn't a toga. It was my leather tightys with red cape "300" outfit.